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Dec 13

How to Recover from a Concussion

By Christian Seguin Homepage, Physiotherapy, Treatment

No doubt you’ve heard lots about concussions in the news. Perhaps you’re already aware that hits to the head could result in concussions and the symptoms that accompany them: headache, pressure in the head, neck pain, nausea or vomiting, dizziness, blurred vision, balance issues, visual disturbance, sensitivity to light, memory loss, concentration issues, confusion, depression, emotional changes and sleeping disorder. That’s the short list. There are many other symptoms, too many to name.

The way concussions are managed has changed greatly in the past five years, especially in the past year. Concussion management has become a multidisciplinary approach that addresses more than headaches and difficulties related to concentrating.

Concussion care is a multidisciplinary venture involving child, parent, coach, teacher, physiotherapist, physician, nurse practitioner and optometrist. When needed, neurologist, ENT specialist, psychologist, neuropsychologist and other medical specialist may be called in to help.

Recognize the signs

The first thing to do is to recognize the signs and remove the person from playing whatever sport they are engaged in. Continuing to play could aggravate the condition and has been shown to double the recovery time. For parents, coaches and trainers, there is a Concussion Recognition Tool (for use with adults and children) that can be downloaded here. It’s a good idea to carry a printout in your first aid kit!

Seek out a professional assessment

If you’re the person who has suffered the concussion, it’s important to have the get a full assessment from a physician, physiotherapist or nurse practitioner trained in concussion assessment to acquire a post-injury baseline and to monitor changes over the following weeks. Typically, they’ll use the SCAT 5 (Sport Concussion Assessment Tool – 5th Edition), developed by world leaders and researchers in the field. It’s important to note that SCAT 5 is endorsed by the Canadian medical community, the International Olympic Committee and several international sport federations.

Have a rest period

It is important to have 48 hours of rest following the injury. This is very important. (Note: Sometimes the concussion signs can be delayed and a longer rest period is needed.) Following this rest period, if appropriate, your medical practitioner may decide on a return to light activities—walking, occasional text or email, occasional reading can be introduced during a trial period.

Children affected with concussion need to be assessed differently – they are not simply smaller adults. It is important to prioritize a symptom-free return to school before a symptom-free return to sports/activities.

Progress to light activities, cardio and tasks

If symptom-free, your medical practitioner will help you progress gradually in intensity. First attempt light activities and light cardio, then move on to sport-specific light tasks. Make sure you work with a health professional trained in concussion management to monitor you for headaches and other symptoms of concussion, balance, endurance, visual disturbances, concentration, processing and memory.

Be patient

At times, symptoms are persistent despite your best effort to rest and resume normal daily activities. Things don’t always progress quickly or at least as quickly as you’d like. A trained medical personnel needs to establish if the persistence of symptoms is due to neck troubles, vestibular dysfunctions (inner ear) or if you require Cognitive Behaviour Therapy (for depression, mood or behaviour issues).

Understand what physiotherapy will do for you

When you first visit your physiotherapist, they’ll inventory your symptoms and how they affect you. As the neck can be a contributor to headaches and dizziness, they’ll assess the impact of its dysfunctions on your symptoms.

They’ll follow that up with a series of balance tests to identify the source of the lack of balance and/or dizziness. Remember that your physiotherapist’s role is to treat neck dysfunctions and labyrinth (inner ear)/balance problems. If they detect dysfunctions outside their spectrum of care, they’ll be sure to refer you to another specialist.

If they do identify neck or balance problems, or general conditioning issues, they’ll engage in a series of interventions to address these.

Don’t do it alone

Recovering from a concussion can be overwhelming and the symptoms can affect physical and mental health. Your progress need to be monitored objectively and medically. Assessment and follow-up with your physician/nurse practitioner is essential. Working with a sport physiotherapist trained in concussion management, (like those at Active Sport Physiotherapy Clinic), is an important part of getting you back on your feet quickly.

Get trained

If you are a coach, athletic therapist, trainer, first aider or parent, you might be interested in booking a FREE Concussion Recognition and Management Clinic. Please reach out to learn more. It’s part of our community service program!

Oct 25

Why Physiotherapy is Beneficial for Everyone

By Christian Seguin Homepage, Physiotherapy

We’ve all experienced muscle or joint pain after exercising or following a hard day’s work. But when these pains extend one or two days past the workout and limit normal everyday movements, you’ll need to see a physiotherapist.

What happens when you injure yourself

During exercise, your muscles, joint and tendons warm up and fill with blood—a process that provides nutrients and oxygen, and releases lactic acid and CO2. This process allows the body to optimize body tissue repair and maintenance.

When you engage in a light level of activity, your body repairs itself automatically and adapts to new works loads. Your body’s structure become more efficient and geared towards performance. It’s a process called overload exercise principle.

But…things can go wrong. In your attempt to work harder or exercise beyond what you’re used to, muscle tissue and joints can breakdown. When you take things too far, your body’s structure become red, swollen and painful on the inside, and are subject to small micro-ruptures. This results in overuse injuries.

So, it doesn’t matter if you’re a worker or an athlete. Injuries happen. Physiotherapy is there to help repair the damage. Your physiotherapist—like the friendly physiotherapists at Active Sport Physiotherapy Clinic—can help you identify the affected structure and mechanism of injury, analyze the faulty biomechanics (movements) to correct and prevent re-injury, and set you up with a stretching and strengthening program. Their goal is to help you recover and return to your regular activities.

What happens when you don’t listen to your body

When you have repetitive irritations, inflammation can become chronic. What could have healed in a period of two to six weeks may linger for three to six months. This happens when a simple inflammation—a mix of redness, heat, pain and tissue irritation—that would normally heal in a few day/weeks changes in chemistry resulting in vulnerable tissue. In other words, when you don’t listen to your body, you can injure yourself more easily!

The four-step solution

There are ways to avoid injury in the first place.

Identify the aggravating factors and minimize them.

This sounds easy but can be complicated, especially when those aggravating factors come from tasks we need to complete for work, or for everyday living like walking, holding, carrying, lifting and so on. A physiotherapist can help you make ergonomic choices to avoid motions that irritate your body.

Support the structure.

When it makes sense, you can use a brace for a wrist injury, tendonitis, carpal tunnel, shin splints, chronic ankle sprain or any other overuse injuries. These supports will help you reach a speedy recovery. (As an aside our Bracing Corner has all the bracing you might need.)

Stretch the affected structures.

When inflamed, a tendon or muscle shortens as it heals (similar to how a skin scar pulls inward). You need to heal these in an elongated position to avoid constant re-tearing and re-irritation of the injury. You do this by stretching!

Strengthen to prevent recurrence.

Once lengthened, your tissues are less vulnerable to movement and are ready to get strong again. By strengthening it over several weeks to months, you will gradually reverse the process of chronic inflammation and allow the tissue to receive load once more.

Why should you see a physiotherapist?

A physiotherapist is a specialist in movement, function and body mechanics, trained in various sub-specialties including orthopedics, sports, ergonomics, occupational injuries, neurology, and cardiovascular conditions. These are the experts who know how to identify and treat problems using the most effective modalities, who can set up and support you through programs, and can also help you avoid future injuries. They’re trained to help everyone—from the everyday worker to the amateur athlete to the high-performance professional.